SHANNON K IDZIK CRNP NPI 1467445924

NPI Information

NPI: 1467445924
Provider Name: SHANNON K IDZIK, CRNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
655 W LOMBARD ST
345
BALTIMORE, MD
ZIP 21201
Phone: (410) 706-8129
Get Directions

Shannon K Idzik, CRNP is a primary care nurse practitioner in Baltimore, MD with 21 years of experience. Shannon K Idzik, CRNP NPI is 1467445924. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

655 W LOMBARD ST
345
BALTIMORE, MD
ZIP 21201-512
Phone: (410) 706-8129
Fax: (410) 706-0344

The NPI 1467445924 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/30/2005 and was last updated on 1/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	R131534	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q19895	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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